不同穿刺方向的椎体成形术治疗老年骨质疏松椎体压缩性骨折的疗效对比

发布时间：2018-03-01 21:25

本文关键词： 椎体成形术骨水泥渗漏穿刺方法骨质疏松　出处：《中国老年学杂志》2017年16期 　论文类型：期刊论文

【摘要】：目的比较不同穿刺方向的椎体成形术(PVP)治疗老年骨质疏松椎体压缩性骨折的临床疗效。方法老年骨质疏松椎体压缩性骨折行PVP治疗188例(214节椎体),根据不同的穿刺方向分为3组,A组为经椎弓根向椎体上1/3方向穿刺,B组为向中1/3方向穿刺,C组为下1/3方向穿刺,对所有患者进行术前1 d、术后1 d、1 w的疼痛视觉模拟评分(VAS),术前及术后1 w进行功能障碍(ODI)评分,术后复查X线片及CT检查评估骨水泥渗漏率。结果 3组VAS及ODI评分术前、术后比较差异有统计学意义(P0.01),但各组间差异无统计学意义(P0.05)。A组穿刺法与其他两组骨水泥渗漏率比较有明显统计学意义(P0.01),B、C组差异无统计学意义(P0.05),同一穿刺方向的椎体球囊扩张后凸成形术(PKP)法与PVP法比较差异有明显统计学意义(P0.01)。结论经椎弓根向椎体上1/3穿刺进针方向行PVP治疗老年骨质疏松压缩性骨折可以有效减少骨水泥的渗漏,且无论哪种进针方向PKP较PVP骨水泥渗漏率低。
[Abstract]:Objective to compare the clinical effects of vertebroplasty with different puncture directions in the treatment of senile osteoporotic vertebral compression fractures. Methods PVP was performed in 188 patients with osteoporotic vertebral compression fractures. The puncture direction was divided into 3 groups. Group A was punctured through pedicle to the upper vertebral body in 1/3 direction. Group B was punctured in the middle and 1/3 directions. Group C was punctured in the lower 1/3 direction. All patients were assessed with visual analogue score of pain 1 day before operation, visual analogue score of pain 1 week after operation, dysfunction score before and 1 week after operation. The rate of bone cement leakage was evaluated by X-ray and CT examination after operation. Results the VAS and ODI scores were evaluated before and after operation. The difference was statistically significant (P 0.01), but there was no significant difference between the two groups. There was no significant difference in the leakage rate of bone cement between group A and the other two groups. There was no significant difference in the leakage rate of bone cement between group A and the other two groups. There was no significant difference between group A and group C (P 0.05%), but there was no significant difference between group A and group A (P 0.05%) in the same puncture direction. There was significant difference between kyphoplasty and PVP in the treatment of senile osteoporotic compression fractures. Conclusion PVP can effectively reduce the leakage of bone cement through the pedicle of vertebrae to the 1/3 puncture needle to the upper vertebral body in the treatment of osteoporotic compression fractures in the elderly. The leakage rate of PKP was lower than that of PVP.
【作者单位】：福建医科大学附属南平第一医院骨科;
【分类号】：R687.3

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